Brand of the Year: Januvia

The problem with uncontrolled diabetes is that it doesn't hurt right away. That's good and bad. It's good in that most patients don't initially experience pain associated with adult-onset Type 2 diabetes, the most common form of the disease. Like high cholesterol levels, the symptoms associated with high blood glucose levels usually aren't manifest in patients at first. And when the telltale symptoms of diabetes do emerge—fatigue, hunger, excessive thirst, and a resulting increase in trips to the restroom—they are easily overlooked or ignored entirely.

This is bad because it minimizes the incentive to see a doctor. Seeing a doctor can require time off work. Once diagnosed, the prescriptions cost money, which is especially hard for seniors on fixed incomes. These factors work against the critical importance of maintaining stable blood glucose levels. Failure to maintain the proper blood glucose levels over time will almost certainly lead to severe, if not life-threatening complications. These debilitating and enormously expensive complications, include, but are not limited to, heart disease, neuropathy and amputation, skin disorders, impotence, coma, and death. The cost of diabetes in the United States alone, including direct medical costs and indirect costs related to disability, work loss, and premature mortality, was approximately $174 billion in 2011, according to a joint report from the American Diabetes Association, CDC, and NIH. Diabetes is also the leading cause of kidney failure and new cases of blindness in the United States.

Top 10 Countries for People with Diabetes

But nothing really happens if a Type 2 diabetic decides to substitute his medication for a couple of pixy sticks and a cigarette on any given day. In less developed nations, the decision to forego medication may seem more like a necessity than a choice; if a patient with diabetes isn't visibly sick, shouldn't a family's limited resources be devoted to more urgent needs? According to the World Health Organization (WHO), 347 million people worldwide have diabetes, 90 percent of which have Type 2 diabetes. In 2004 roughly 3.4 million died as a direct consequence of the disease. Over 80 percent of those deaths occurred in low and middle-income countries. The WHO expects diabetes-related deaths worldwide to increase by two-thirds between 2008 and 2030. In the United States, 24 million people had diabetes in 2009, and that number will nearly double by 2034, according to NIH projections.

While diabetes isn't contagious, the staggering increase in worldwide incidence of the disease in recent decades has been referred to as a pandemic, with all of the hair-raising urgency that term connotes. The concern is justified, but the problem remains: as economies in developing countries continue the transition from labor-intensive industries to the mechanized, information-age sedentariness of office life—salted with the fatty, carbohydrate-laden foodstuffs proffered by western food chains that almost always accompany this transition—how can the life sciences industry help to stem the tide of disease on a global basis?